title: Handling of the tibial muscle envelope in tibial plateau levelling osteotomy - to elevate or not? A clinical study of 40 dogs.
abstract: OBJECTIVE
  To compare the outcome of the tibial plateau levelling osteotomy (TPLO) procedure, using a 6-hole 3.5 mm locking TPLO plate and performed with the muscle elevation technique (ET) and placement of sponges, to the TPLO without performing these steps (non-elevation-technique [NET]).
  
  
  METHODS
  Medical records and radiographs of dogs with ET (n = 21) or NET (n = 19) were retrospectively reviewed. Signalment, TPLO procedure side, meniscal treatment, surgery time, haemorrhage, pre- and postoperative tibial plateau angle, assistant, amount of rehabilitation, bone healing (cortical, osteotomy, combined healing scores), complications, limb function, recovery time and follow-up were recorded and analysed using multivariate analysis. A value of p <0.05 was considered significant.
  
  
  RESULTS
  Surgery time was significantly shorter with the NET (68.5 min ± 3.4) than with the ET (87.8 min ± 3.4) (p <0.01). No significant differences were detected for all other evaluated factors. Soft tissue trauma was minimal and none of the dogs suffered severe haemorrhage. The bone healing scores with the NET and the ET were not significantly different (p = 0.1, p = 0.2, p = 0.1). Complications were rare, minor and not significantly different between groups (p = 0.73).
  
  
  CONCLUSIONS
  The results of this in vivo study indicate that NET is a feasible technique that can be considered for the clinical setting.
authors.affiliation: Dirsko J. F. von Pfeil, Dr.med.vet, DVM, Diplomate ACVS, Diplomate ECVS, Veterinary Specialists of Alaska, P.C., 3330 Fairbanks Street, Anchorage, Alaska 99503, United States, Phone: +1 907 274 0645, Fax: +1 907 929 3320, E-mail: drvonpfeil.vsoa@ak.net.
authors.forename: D J F
authors.initials: DJ
authors.lastname: von Pfeil
authors.forename: M R
authors.initials: MR
authors.lastname: Edwards
authors.forename: N C
authors.initials: NC
authors.lastname: Nelson
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D005260:Female; D006614:Hindlimb / Q000033:anatomy & histology; D008297:Male; D010027:Osteotomy / Q000379:methods / Q000662:veterinary*; D011183:Postoperative Complications / Q000601:surgery / Q000662:veterinary; D012189:Retrospective Studies; D013264:Stifle / Q000601:surgery*; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome
keywords: Tibial plateau levelling osteotomy; dog; muscle envelope; popliteal artery; popliteal vein; stifle